title: HeartBeat--improving heart attack care.
abstract: We aimed to save lives by assuring best practice in ST elevation myocardial infarction (STEMI) through initiating the Institute for Healthcare Improvement (IHI) methodology nationally. Following collection of a minimum dataset, annual change in indicators in the five initiating hospitals for the period Oct 2006 - Sept 2009 was assessed by analysing the percentage of patients receiving the eight components of evidenced based care on admission and discharge and in-hospital mortality rate. For 635 patients, performance on seven of the eight indicators of care exceeded 90% annually. Timely reperfusion therapy (thrombolysis, primary percutaneous coronary intervention (PPCI)) improved non-significantly from 68.2% (107 patients) in year 1 to 77.1% (118 patients) in year 3. In-hospital mortality declined significantly from 12.4% (24 deaths) in year 1 to 5% (9 deaths) in year 3. Evidence based STEMI care is followed to a high degree but timely reperfusion and PPCI provision remain a challenge nationally.
authors.affiliation: HSE--Department of Public Health, Dr Steeven's Hospital, James's St, Dublin 8. Siobhan.jennings@hse.ie
authors.forename: S
authors.initials: S
authors.lastname: Jennings
authors.forename: K
authors.initials: K
authors.lastname: Bennett
authors.forename: B
authors.initials: B
authors.lastname: Cavanagh
authors.forename: M
authors.initials: M
authors.lastname: Morrissey
authors.forename: P
authors.initials: P
authors.lastname: Kearney
mesh_terms: D000328:Adult; D000368:Aged; D019317:Evidence-Based Medicine; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D015425:Myocardial Reperfusion; D015912:Thrombolytic Therapy